A Retrospective Study Of 181 In-patient Cases Of Drug Eruptions

Objective:Based on the investigation of 181 in-patient cases of drug eruptions in the Department of Dermatology of Peking Union Medical College Hospital in the recent 5 years,analyzing the epidemiological characteristics,allergenic drugs,clinical characteristics,laboratory examination and treatment of drug eruptions.We aim to provide an objective evidence for the diagnosis,prevention and treatment of drug eruptions in the future clinical work.Methods:Collecting the patients who were diagnosed as drug eruptions in the Dermatology Department of Peking Union Medical College Hospital from January 1,2013 to December 31,2017.The sex of patients,age of onset,length of stay,type of drug eruptions,allergenic drugs,accompanying diseases,primary diseases,incubation period,febrile peak,past drug sensitivity,lymph node involvement,skin involvement,mucosal involvement,laboratory examination,maximum corticosteroids dosage,IVIG,antihistamine and other items will be registered.Excel software is used to establish the database of drug eruption cases.The collected data will be analyzed statistically.Results and Conclusions:1.The top five allergenic drugs were anti-infective drugs,traditional Chinese medicine,non-steroidal anti-inflammatory drugs,anti-epileptic drugs and allopurinol.Amoxicillin and cephalosporin were the most common anti-infective drugs.2.The top five types of drug eruptions of in-patient cases were SJS/TEN,maculopapular drug eruption,erythema multiforme-like drug eruption,urticaria type drug eruption and erythroderma type drug eruption.3.The top five primary diseases of drug eruptions were upper respiratory tract infection,skin diseases,pain,hyperuricemia and fever.4.The top five accompanying diseases of drug eruptions were hypertension,cardio-cerebrovascular diseases,skin diseases,liver or kidney diseases,and diabetes.5.Severe drug eruptions always get high fever;liver injury induced by drug eruptions often occur in DRESS and TEN,especially DRESS;leukocytopenia can occur in TEN.6.In addition to liver or kidney involvement,drug eruptions may also get involved in multiple organ systems such as gastrointestinal tract,pancreas,lung,myocardium and neuropsychiatric system.7.The corticosteroids dosages of SJS/TEN,erythema multiforme major,drug-induced hypersensitivity syndrome,acute generalized exanthematous pustulosis are generally more than 60mg(prednisone equivalent);IVIG is one of the important treatment for TEN;antihistamines are mainly used in mild drug eruptions,less used in severe drug eruptions.8.There were statistically significant differences in the mouth and vulvar mucosal involvement between the two groups of erythema multiforme major and Stevens-Johnson syndrome,the mucosal involvement of Stevens-Johnson syndrome was more serious than that of erythema multiforme major.9.The statistical comparison between the two groups of mild and severe drug eruptions showed that the febrile peak,the peak of ALT,the skin involvement of the head and neck,the mucosal involvement of mouth,eyes,nose,vulvar,and maximum corticosteroids dosage were statistically significant.In the judgment of the condition of drug eruption,higher fever,liver injury,the skin involvement of the head and neck,and multiple mucosal involvement may be indicative for the occurrence of severe drug eruptions.